Differentiation of viral and autoimmune central nervous system inflammation by kynurenine pathway.
Ann Clin Transl Neurol
; 8(12): 2228-2234, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34623755
ABSTRACT
OBJECTIVE:
To determine whether the metabolites of Kynurenine pathway (KP) could serve as biomarkers for distinguishing between viral CNS infections and autoimmune neuroinflammatory diseases, especially anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) and herpes virus encephalitis (HSE).METHODS:
This study enrolled CSF samples from 76 patients with viral CNS infections, autoimmune neuroinflammatory, and non-inflammatory neurological diseases. We measured cerebrospinal fluid (CSF) concentrations of tryptophan (Trp) and kynurenine (Kyn) by ELISA.RESULTS:
Kyn concentrations and Kyn/Trp ratios were highly increased (p < 0.001, viral vs. autoimmune) in viral CNS infections, whereas patients with autoimmune neuroinflammatory and non-inflammatory diseases exhibited low concentrations. Furthermore, Kyn concentrations and Kyn/Trp ratio turned out to be excellent biomarkers to distinguish between herpes simplex encephalitis (HSE) and NMDARE (AUC 0.920 and AUC 0.906), whereas Trp concentrations were similar in all three groups.INTERPRETATION:
The results suggest that elevated CSF Kyn concentrations and Kyn/Trp ratio may serve as biomarkers for distinguishing viral CNS infections from autoimmune neuroinflammatory diseases. In particular, the distinction between HSE and NMDARE is of great clinical relevance. Further studies are warranted to investigate the potential of CSF Kyn levels and Kyn/Trp ratio as routine parameters in patients with CNS diseases.
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Base de dados:
MEDLINE
Assunto principal:
Triptofano
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Pseudotumor Cerebral
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Encefalite por Herpes Simples
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Encefalite por Varicela Zoster
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Encefalite Antirreceptor de N-Metil-D-Aspartato
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Hidrocefalia de Pressão Normal
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Cinurenina
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Meningite Viral
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Esclerose Múltipla
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article